A team led by researchers at San Diego State University has been awarded $4 million to enhance asthma education and treatment strategies in California's Imperial Valley, where children are twice as likely as the national average to suffer from asthma.

The grant will allow researchers to better understand the specific asthma needs of Imperial Valley's largely Latino/Latina population, as well as develop more effective approaches to treatment for families, communities, and physicians.

Approximately 4.5 million African-Americans and 3.6 million Hispanics and Latinos/Latinas in the U.S. had asthma in 2010. Children from these populations are less likely to be prescribed asthma treatment, and they are also less likely to follow prescribed treatment regiments. In 2012, Imperial County children visited emergency clinics with uncontrolled asthma twice as frequently as other children in California. Approximately 75 percent of those children are Latino.

Asthma control is influenced by many factors, including how well the child and his or her family manage the asthma, their use of health care services, and the environment in which they live.

This month marks the start of a new research project funded by the Patient-Centered Outcomes Research Institute (PCORI). PCORI has awarded $4 million to John Elder, Ph.D., and Guadalupe X. Ayala, Ph.D, of SDSU's Institute for Behavioral and Community Health, as well as its partners Clínicas de Salud del Pueblo, Inc., Comité Cívico del Valle, Inc., and the California Department of Public Health's California Breathing program, to study ways to decrease rates of uncontrolled asthma among Latino children in Imperial County. Imperial County was among eight sites across the U.S. selected to receive PCORI funding targeting better asthma control among Hispanics/Latinos and African-Americans.

Improve control, minimize complications

The Imperial County asthma research project, also known as the Imperial County Asthma CER Project, will evaluate a multifaceted approach to improve asthma control and minimize complications among children with asthma. This collaborative will work to improve patients', families' and healthcare providers' adherence to treatment guidelines. Community health workers will visit families' homes to develop tailored asthma management strategies and help families identify ways to control environmental triggers. A school program and a communications campaign will inform Imperial County communities about air quality and how to adjust indoor and outdoor activities to prevent adverse health outcomes, such as asthma episodes.

"Parents assume their kids can manage a lot more of their care on their own than may be true," Ayala said. "We need to train kids how to be self-dependent. That leads to better adherence, which leads to improved quality of life." She and Elder are professors at SDSU's Graduate School of Public Health.

In addition to assessing asthma control, the researchers will determine whether the project is successful in minimizing the impact of the illness on the family, in terms of reducing absences from school and work, and improving the family's quality of life.

Culturally appropriate care

"Through these awards, we're supporting efforts to discover the most effective ways to bring asthma under control in populations that are suffering the most," said Romana Hasnain-Wynia, director of PCORI's Addressing Disparities Program. "Compared to other populations in the United States, racial and ethnic minorities experience the highest rates of uncontrolled asthma and its ill effects, which include missed school and work days and anxious trips to the emergency department."

Not all types of asthma care may be optimal for all populations, and treatments beneficial to some groups may be less beneficial to others. Moreover, research shows that disparities in health and health care have multiple causes, including social and economic factors as well as health-related issues. The Imperial County Asthma CER Project hopes to shed light on effective solutions for Latino children.

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